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210820

Revisiting The Value of Anti-streptolysin O Titer in Children with Rheumatic Fever

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Last updated: 04 Jan 2025

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Abstract

Background: Acute rheumatic fever and rheumatic heart disease are the significant non-suppurative late sequelae of group A beta hemolytic streptococcal infection. Anti-streptolysin O titer (ASOT) is a streptococcal antibody test that is used for the diagnosis of infections and is particularly useful in the diagnosis of acute rheumatic fever.  Aim of the work: To compare ASOT values in normal children to those with rheumatic fever and children with recurrent tonsillitis, and to evaluate its relationship with seasonal variations.  Methods: A case-control study conducted on 300 children; 100 children with rheumatic fever, 100 with recurrent tonsillitis and 100 apparently healthy children as a control group. Children were subjected to history taking, echocardiography study and blood specimens for complete blood count, erythrocyte sedimentation rate, C reactive protein and ASOT were assessed using immunoturbidimetric assay tested by Cobas e501/502 (Roche). Human anti-streptolysin O antibodies (any type) agglutinate with latex particles coated with streptolysin O antigens.  Results: Mean and SD of age in each group was 10.2±3 years for rheumatic fever group, 7.3± 3.8years for recurrent tonsillitis group and 5.4±2.4 years for control group. Rheumatic fever group included 49 males and 51 females, recurrent tonsillitis group included 58 males and 42 females, control group included 63 males and 37 females. ASOT ranged between 261-860 (mean± SD= 475.1±214.2), 210-813 (mean± SD= 257.6±56.4) and 65- 820 (mean± SD= 158.8± 105.4) among those with rheumatic fever, tonsillitis and control group respectively (p=0.001). ASOT level between 400-800 IU/ml were common among patients with rheumatic fever and levels between 200-400 IU/ml were common with recurrent tonsillitis (p < 0.001) with lack of diagnostic cut-off.  Conclusion: ASOT levels are higher in rheumatic fever patients compared with recurrent tonsillitis and normal children. There is lack of diagnostic cut-off of ASOT, hence the value of ASOT is only within scoring system to avoid over or under diagnosis of acute rheumatic fever. An isolated high ASOT is not sufficient to diagnose or rule out acute rheumatic fever.   

DOI

10.21608/cupsj.2021.106125.1034

Keywords

Acute rheumatic fever, Anti-streptolysin O titer, Recurrent tonsillitis

Authors

First Name

Mohamed

Last Name

Eid

MiddleName

Samir

Affiliation

Pediatrics Department, Faculty of Medicine, Cairo University, Egypt

Email

pediatric_medo@yahoo.com

City

Cairo

Orcid

0000-0003-4245-7482

First Name

Fatma Al Zahraa

Last Name

Mostafa

MiddleName

-

Affiliation

Pediatrics Department, Faculty of Medicine, Cairo University, Egypt

Email

fatmaalzahraah@hotmail.com

City

-

Orcid

0000-0002-9624-2375

First Name

Hend

Last Name

Tamim

MiddleName

-

Affiliation

Clinical and Chemical Pathology Department, Faculty of Medicine, Cairo University, Egypt

Email

hend-tamim@hotmail.com

City

-

Orcid

-

First Name

Mohammed

Last Name

Elberry

MiddleName

-

Affiliation

Pediatrics Department, Faculty of Medicine, Cairo University, Egypt

Email

mohammed_elberry@hotmail.com

City

-

Orcid

-

First Name

Shaimaa

Last Name

Sayed

MiddleName

-

Affiliation

Pediatrics Department, Faculty of Medicine, Cairo University, Egypt

Email

shaimaasayed@kasralainy.edu.eg

City

Cairo

Orcid

0000-0002-9009-165X

Volume

2

Article Issue

1

Related Issue

29646

Issue Date

2022-01-01

Receive Date

2021-11-15

Publish Date

2022-01-01

Page Start

54

Page End

61

Print ISSN

2805-279X

Online ISSN

2682-3985

Article File

CUPSJ_Volume 2_Issue 1_Pages 54-61.pdf

PDF . 721.9kB

Link

https://cupsj.journals.ekb.eg/article_210820.html

Detail API

https://cupsj.journals.ekb.eg/service?article_code=210820

Order

8

Type

Original Research

Type Code

1,229

Publication Type

Journal

Publication Title

Pediatric Sciences Journal

Publication Link

https://cupsj.journals.ekb.eg/

MainTitle

Revisiting The Value of Anti-streptolysin O Titer in Children with Rheumatic Fever

Details

Type

Article

Created At

22 Jan 2023